Laryngectomy: what is the impact of the type of surgery on life quality and sexual function?

The purpose of this study is to compare total and partial larygectomy on private life functions and sexuality in patients with laryngeal cancer. The study included 31 partial laryngectomy patients (Group 1) and 51 total laryngectomy patients (Group 2) who were operated for laryngeal cancer. European Organization for Research and Treatment of Cancer (EORTC) head and neck cancer module (QLQ-H&N35) and Arizona Sexual Experiences Scale (ASEX) forms were filled in by interviewing face to face with patients. HNSW (swallowing), HNSE (senses), HNSP (speech), HNSO (social eating), HNSX (sexuality), HNTE (problems with teeth), HNOM (problems with opening mouth) and HNCO (coughing) scores of EORTC QLQ-H&N35 were significantly higher in group 2 than in group 1. However, according to Arizona test results, there were no significant difference between the two groups.

Vestibular migraine screening in a migraine-diagnosed patient population, and assessment of vestibulocochlear function.

OBJECTIVE: The primary aim of this study is to do a vestibular migraine scan in a population of patients with migraine diagnosis using the most recent standardized diagnosis criterion which is International Classification of Headache Disorders (ICHD) 3 Beta and to identify the epidemiological data. The second part of the study involves performing several vestibulocochlear tests on patients who received vestibular migraine (VM) diagnosis to collect data that may be important for diagnostic purposes by comparing the patients with normal population when necessary. DESIGN: Blind, cross-sectional study. SETTING: Tertiary referral hospital. PARTICIPANTS: One hundred patients were scanned for VM using ICHD 3 Beta guideline. MAIN OUTCOME MEASURES: In order to evaluate the vestibulocochlear functions of the patients with VM diagnosis, audiometry, tympanometry, electrocochleography (EcochG), computerized dynamic posturography (CDP) and video head impulse test (vHIT) were performed; besides in order to evaluate the significance of the results of the tests, second group was formed with migraine patients without any vestibular complaints and control group was formed from healthy population when needed. RESULTS: VM prevalence was determined to be 21% in migraine patients which is much higher than stated in current literature. No significant difference was observed between migraine and VM patients with respect to audiometric and tympanometric measurements. According to the CDP results, balance defects were present in VM patients, even during attack-free periods. EcochG data suggests average SP/AP scores of VM patients are significantly higher than migraine patients. Furthermore, the number of patients who exceeded a limit value of 0.4 or 0.5 in SP/AP scores was significantly higher in VM patients than in migraine patients. Also vHIT results show that nearly half the VM patients, which is a significant ratio, have saccadic movements and this is thought to be compatible with peripheral vestibular involvement. CONCLUSION: Our results suggest VM disease is more common than previously thought. We believe that further EcochG-based studies would shed light on the controversial topic on the intersection and disjunction sets of MD and VM diseases. Although the results of the present study are compatible with peripheral vestibular effects, it is not possible to rule out another central mechanism at some other level.

Can temperament and character features of patients predict alcohol use after laryngectomy?

AIM: Patients with larynx cancer usually use alcohol besides tobacco. It has been reported earlier that nearly half of the patients who have undergone laryngectomy after larynx cancer diagnosis still continue to consume alcohol after the operation. The aim of this study was to compare the mood and character features of patients who do or do not consume alcohol during the postoperative period and thus to be able to predict the patients who will continue their alcohol use at the postoperative period. MATERIALS AND METHODS: The patients who have undergone partial or total laryngectomy operation were included in this study. To avoid early period treatment stress, it was required that the patients have completed their 6 months of postoperative period. The interviews made with the patients included filling out of the sociodemographic data form, TCI (temperament and character inventory), BDI (Beck depression inventory), BAI (Beck anxiety inventory), AUDIT (alcohol use disorders identification test) and CAGE (cut-down, annoyed, guilty, eye-opener) inquiry forms. RESULTS: 80 patients who admitted alcohol consumption at the time of larynx cancer diagnosis were divided in to two groups and, 40% (n = 32) of this patients continued alcohol consumption after laryngectomy (Group 1) and 60% (n = 48) cut down on their alcohol use (Group 2). A statistically significant difference was observed between Group 1 and Group 2 at AUDIT and CAGE score averages (P < 0.001, P < 0.001, respectively). When TCI data were compared between Group 1 and Group 2, patients who continued their alcohol use at the postoperative period had significantly higher novelty seeking scores compared to others (P = 0.03). CONCLUSION: Our data suggest that it may be possible in the preoperative period to predict the patients who will continue their alcohol use in the postoperative period and take precautions.

Depression, self-esteem and sexual function in laryngeal cancer patients.

OBJECTIVE: The purpose of this study was to assess sexual function, affective disorders and self-esteem in patients who were surgically treated for laryngeal cancer. DESIGN: Retrospective, blind, cross-sectional study. SETTING: Single tertiary cancer centre. PARTICIPANTS: Seventy four patients who were operated on Istanbul University Cerrahpasa School of Medicine Otorhinolaryngology Department between 2008 and 2012 were classified according to the type of the operation as total laryngectomy (Group 1) and partial laryngectomy (Group 2). MAIN OUTCOME MEASURES: Sexual dysfunction, depression and self-esteem were evaluated with The Arizona Sexual Experiences Scale (ASEX), Beck's Depression Inventory (BDI) and Rosenberg Self-Esteem Scale (RSES), respectively. RESULTS: Average ASEX scores of the Group 1 were (13.98 ± 6.32) and Group 2 were (13.08 ± 4.96) without statistically significant difference (P = 0.537). Mean BDI score of Group 1 was (13.20 ± 10.41) higher than Group 2 (7.76 ± 8.14) and the difference was significant statistically (P = 0.026). Mean RSES scores of Group 1 and Group 2 were 20.68 ± 5.33 and 19.25 ± 4.70, respectively, again without significant difference (P = 0.262). However, when the average scores of each item of Rosenberg Scale were compared, significant difference was found in d4 (2.37 ± 0.78; 1.64 ± 0.99; P = 0.001), d6 (1.22 ± 1.05; 1.84 ± 1.14; P = 0.023), d10 (2.55 ± 2.39; 1.28 ± 1.49; P = 0.018) and d11 (1.35 ± 0.95; 2.00 ± 1.41; P = 0.021). BDI scores were correlated with RSES scores, and ASEX scores were correlated with age. CONCLUSION: The patients with total laryngectomy seem to have more psychological problems that must be addressed in the postoperative period.